(1087) Placental histopathological lesions and adverse neonatal outcomes in patients with Inflammatory Bowel Diseases

To investigate the relationship between inflammatory bowel diseases (IBD), including Crohn's disease and Ulcerative Colitis, and adverse pregnancy outcomes by comparing neonatal outcomes and placental histopathology in two matched groups of patients with and without IBD.

Study Design:

In this retrospective study, data of all patients who gave birth between 2008-2021 in a single tertiary center and were diagnosed with IBD were reviewed and matched in a 2:1 ratio with a control group based on maternal age, gestational age, and pregnancy complications. Neonatal outcomes and placental pathology were compared between cases with and without IBD.

Results:

Compared to the control group (n=76), the placentas of patients with IBD (n=36) were characterized by significantly lower placental weight (p < 0.001), and higher rates of several placental lesions including lesions associated with maternal vascular malperfusion (MVM, p < 0.001) and maternal and fetal inflammatory response lesions (p < 0.001) – Table.

Small for gestational age (SGA) birthweight was more prevalent in the IBD compared with the control group (p=0.01). Additionally, neonates of patients with IBD suffered from an increased need for phototherapy (p = 0.03), increased respiratory morbidity and NICU admission rates (both p < 0.001).

Multivariate logistic regression analyses confirmed the independent association between IBD and composite MVM lesions (aOR 4.2, p = 0.01), maternal inflammatory responses (aOR 4.8, p < 0.001) and SGA infants (aOR 4.0, p = 0.05) after controlling for possible confounders.

Conclusion: IBD is associated with increased rates of placental histopathological lesions and adverse pregnancy outcomes, including SGA infants. These novel findings demonstrate the role of placental malperfusion and inflammatory processes in pregnancy complications of IBD patients, which should be followed accordingly.